Organization Active NPI

Coastal Chiropractic & Wellness Inc.

  • Chiropractor
  • Madison, CT
National Provider Identifier
1376798983
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001711 Issued in CT
Legal business name
COASTAL CHIROPRACTIC & WELLNESS INC.
Practice address
15 Meigs Ave
Madison, CT 06443-3057
Phone
(203) 245-8217
Fax
(203) 245-9390
NPI assigned
Nov 24, 2008
Last updated
Aug 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Keith William Mirante, DCNPI 1134257405
Title
Owner
Phone
(203) 245-8217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001711 CT Primary

Addresses

Primary practice location

15 Meigs Ave
Madison, CT 06443-3057

Mailing address

15 Meigs Ave
Madison, CT 06443-3057
Phone (203) 245-8217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081208000489 CT Part B Supplier - Clinic/Group Practice 4284795378 Receives reassigned benefits from 3 practitioners
Practice locations: Madison, CT

National Provider Directory

National Provider Directory

Locations

15 Meigs Ave
Madison, CT 06443
Phone (203) 245-8217

15 Meigs Ave
Fl 1
Madison, CT 06443
Phone (203) 245-8217

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1376798983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEIGS AVE",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433057",
            "telephone_number": "203-245-8217",
            "fax_number": "203-245-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEIGS AVE",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433057",
            "telephone_number": "203-245-8217",
            "fax_number": "203-245-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CHIROPRACTIC & WELLNESS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "MIRANTE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-245-8217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.